A recent study, published in the European Spine Journal, investigated the link between levels of physical activity, physical fitness and the incidence of low back pain. The study was conducted in the Netherlands and asked a population of police officers about their activity levels and episodes of low back pain over the preceding 12 months. In addition to questioning, their levels of physical fitness were actually measured objectively (hence minimising the problem that often arises with this sort of study where people inaccurately record their activity levels, often tending to over-report). Results were collected from nearly 2000 individuals and the findings were conclusive - moderate levels of physical fitness (both muscular and aerobic) correlated with a lower incidence of low back pain, whereas the occurrence of low back pain increased with lower levels of activity and physical fitness. So, the implications of this are clear - exercise regularly, improve your fitness levels and you should experience fewer episodes of low back pain! However, it is not quite that simple - it may be that people refrained from exercise due to their low back pain, hence their back pain worsened, hence they exercised less - something of a Catch22 situation! Additionally, the findings showed that excessive levels of exercise actually increased the episodes of low back pain - this was particularly true of highly strenuous, vigorous activities such as weight lifting or heavy gardening and was a problem that mainly affected the male cohort of the study. In conclusion, this study showed that physical activity, strenuous enough to improve physical fitness, was strongly associated with lower levels of low back pain. So, the message is clear - get moving, get fit and you should have less low back pain (but take it gently and sensibly as excessive exercise might cause more harm than good!).
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It's that time of year when our resolve is tested. A week in, and all those New Year resolutions are beginning to fall by the wayside. It is so easy to think that that little bag of crisps won't really hurt, a small glass of wine doesn't really count and I'll go for a run tomorrow when it's stopped raining... Like most people, I vowed to have a healthy start to the year. A week of eating and drinking too much (I was away snowboarding over Christmas so had to join in the apres-ski!) left me feeling tired, jaded and a bit podgy round the middle. I packed away the Christmas decorations, cleaned out the kitchen cupboards, finished the half-eaten packet of biscuits and tin of Roses and dug out my running trainers, head-torch and high vis jacket. A healthy eating campaign, with lots of nutritious fresh fruit and veg, plenty of water, and no alcohol or rubbishy snacks beckoned, with a daily jog around the village - no matter the weather. One week in and I've been flawed by a forgotten box of Ferrero Rocher and the remnants of a chest infection. Not wanting to make it any worse ('don't exercise if you have symptoms below your neck!') I've refrained from my daily run, and thought that I had the self-control to limit myself to just one little chocolately, nutty nugget... I was wrong. However, all is not lost - working on the premis that tomorrow never comes, I shall just start again today. A healthy stir-fry for supper, and then a walk around the village with a few stretches and core exercises back at home (probably best to let my chest get fully better) and I'm back in the swing of it. And that's what I remind all of my patients - it doesn't matter if you slip up with the diet, or forget to do some exercises, or have a 'greedy' day - you just have to start back where you left off, as soon as you feel ready. So many people throw their entire fitness campaign out of the window simply because they slip up the once - but this is just crazy! You're throwing away all the hard work that you've done, and will quickly get back to where you were - just as soon as you get back on track. So, here's to a fresh start this New Year... even if it is somewhat belated! I enjoyed reading this article written by GB triathlete, Helen Russell. She writes about how chiropractic was available at the London Olympics, the first time that chiropractic was included as part of the mainstream core medical services within the Olympic village. It is estimated that nearly 90% of elite athletes use chiropractic treatment on a regular basis! You can read the full article here... I enjoyed the article, particularly the bit when Helen described her own beneficial experience of chiropractic treatment; she was treated by chiropractor, Stuart Herbert, at the Bromsgrove Chiropractic Clinic - I worked with Stuart many years ago when I had just qualified as a chiropractor! At a recent meeting of the Privy Council in November 2012, the Queen approved the grant of a Royal Charter to the College of Chiropractors, the first Royal Charter to be granted to a complementary medicine organisation in the UK. The College is an academic, professional membership body, established along the lines of the Medical Royal Colleges, which over the past 13 years has sought to ensure quality, safety and excellence are at the forefront of chiropractic practice in the public interest. Chiropractic is regulated by statute and although chiropractors provide their services largely within the private sector, NHS funding for chiropractic treatment is now emerging region by region under the Department of Health’s new commissioning arrangements. Chiropractors specialise in the diagnosis and treatment of problems affecting the joints, muscles and nerves and are probably best known for treating low back pain, a condition which costs the equivalent of between 1% and 2% of the UK GDP and has a significant impact on people’s lives. Rarely granted, a Royal Charter signals permanence and stability and, in the College of Chiropractors’ case, a clear indication to others of the leadership value and innovative approach the College brings to the development of the chiropractic profession. The Royal Charter essentially formalises the College’s position as a unique, apolitical, consultative body, recognising its role in promoting high practice standards and certifying quality and thus securing public confidence. Tim Jay, President of the College, said, “The College of Chiropractors’ Royal Charter emphasises to the public and other health bodies that chiropractic is a healthcare profession with parity in the field of musculoskeletal health, providing a viable and recognised option for patients". Have you ever watched an animal as it prepares to settle down for a nap? Or seen what it does on waking? It stretches. OK, so it might have a bit of a wash too, or circle the ground a few times (apparently dogs do this from their 'wild days' when they would flat down a circle of grass to make a comfy bed), but it will always take time to stretch. This is one of the many things that we humans have forgotten to do as we've evolved, but stretching regularly is really useful - it eases out the joints, loosens the muscles and helps the circulation. One of my favourite stretches is the Cat Stretch; it's quick and easy to do and loosens up the entire back, stretching out all the long muscles that run parallel to the spine and mobilising all the little joints between each vertebra. I encourage most of my patients to do it every day, morning and evening - those that do generally feeler looser and easier with less stiffness and fewer aches and pains. The Cat Stretch Start off on all fours, hands below your shoulders, knees below your hips. Make sure you're evenly balanced, keep your arms straight and strong and draw your belly button in towards you spine so your tummy doesn't 'sag' down to the floor. Gently arch your back, pushing your rib cage up to the ceiling, tucking your chin to your chest and your bottom underneath you (think of a dog tucking its tail between its legs!). Hold for a count of three, then gently lower back down to the starting position. Don't be tempted to arch the other way, sagging in the middle and sticking your bottom and head out, as this can over-arch the lower back and jam all the joints together - keep your back flat with your tummy muscles gently supporting your spine. Repeat this whole sequence 10 times or so, and do it every morning when you're getting up and last thing before bed. It only takes a couple of minutes and will really help to keep the spine healthy - a bit like cleaning your teeth twice a day keeps your teeth healthy! Sore knees? You can easily do this kneeling on your bed or on a couple of cushions. If it's still too much for your knees then you can do a 'half cat' - stand facing a wall, place your hands on the wall at shoulder height with your knees slightly bent and gently arch your back. Repeat 10 times, morning and evening. Obviously, if you find this stretch uncomfortable, painful or difficult to do, please be sensible and don't do it! Email me, or give me a call and we can work out what the problem is. It's amazing what the human body can do. 128,100ft, 4mins 20 freefall, 833mph - and all done by one truly amazing man. Plus a team of exceptionally clever engineers. The other day, I listened to an interesting piece on Radio 4's health programme, 'Inside Health' on dizziness and vertigo. A number of different types of dizziness were discussed, from orthostatic hypotension (the dizziness experienced when we stand up too quickly due to a temporary drop in blood pressure in the brain) to the management of Benign Paroxysmal Positional Vertigo, or 'BPPV'. This wordy mouthful is a particular type of short duration, rotational dizziness or vertigo that is triggered by a change in head position - for instance when turning over in bed. BPPV is caused by disturbances in the balance receptors of the semicircular canal, buried deep within the inner ear. Sometimes, particularly as we get older, calcium deposits accumulate within the fluid of the inner ear and these tiny 'otoconia' can irritate the sensitive nerve endings, tricking our brain into thinking that we're moving when we're not. A simple test, called the Hallpike test, can be used to diagnose BPPV. Chiropractors are trained to carry out this test and diagnose BPPV and differentiate it from the other types of dizziness that may occur. Medication has little effect in the treatment of this uncomfortable complaint, but there is a simple procedure that can be carried out that helps to reposition the otoconia within the semicircular canal so that they cease to irritate the sensitive nerve endings. This procedure, called the Epley manoeuvre, consists of specific sequence of head and body movements that reposition the loose fragments in the inner ear. The Epley manoeuvre is usually successful in 9 out of 10 cases, and can be repeated if the symptoms return. Not only can chiropractors diagnose BPPV but chiropractors can perform the Epley maneouvre too. So, if you're suffering from dizziness and find that medication isn't helping, it might be worth asking if we can fix it at the Llangefni Chiropractic Clinic! We all know that good posture can not only improve your posture, but improve your overall appearance. We know too that standing up tall, with our tummies in, head held high and shoulders back makes you feel much better and look fantastic - taller, slimmer and generally poised - and can minimise back and neck pain. Ideally, we'd all have the strength and discipline(!) to maintain our own posture, but finally, help is at hand. M&S and the British Chiropractic Association have joined forces and come up with the 'Perfect Poise' TM range of lingerie, a 3 piece range cleverly designed to support and improve your posture. “The Perfect Poise TM range of bras, knickers and shapewear has been specifically designed to increase the wearer's awareness of correct posture by supporting them in key areas. The bra and body incorporate a patent pending supportive back panel and seam-free cups for a smooth silhouette.” Paschal Little, Head of Innovation, M&S Lingerie. The bra and body use hidden back panels to encourage the wearer to keep their shoulders back and the high waisted knickers have an in-built lower back panel which encourages body alignment. They also slim and smooth the tummy to give a more flattened appearance! Independent trials by M&S showed that 87% of the women who tried the undies felt that the products supported their back and the national press have followed the story - although recent reviews do say that they need to increase the cup-size range (currently 34B - 40E, sizes 8 - 22) to accommodate everyone. ‘"Perfect Poise TM lingerie has been designed with the modern woman in mind. Our contemporary aesthetic combines graphic sheer and opaque panels to create sculpted, sleek pieces which are discreet under clothing.’’ Soozie Jenkinson, Head of Lingerie Design, M&S. I'm tempted to try them myself but regrettably require something a little smaller(!), but would love feedback from anyone who's tried them... The National Institute of Clinical Excellence (NICE) has recently published new guidelines on the management of headaches. This will be welcome news to the 10 million people who frequently suffer from headaches in the UK. Clinical Guideline 150 “Headaches – Diagnosis and management of headaches in young people and adults” received input from both the British Chiropractic Association and the Anglo European College of Chiropractic to provide up-to-date, evidence-based advice on the diagnosis and management of tension headaches, migraine, cluster headaches and medication over-use headaches in children and adults. Whilst there is no specific recommendation for manual therapy for the management of primary headaches, in several studies the clinical trials suggest that manual therapy is at least as good as conventional care for headaches. More recent trials, not yet considered by NICE, show more favourable outcomes (1) (2). However, the guidelines also highlight the fact that taking medications, like painkillers, particularly for a prolonged period of time can actually worsen the symptoms, rather than alleviate them. It was reported that up to 1 in 50 people experience headaches that result from taking medication frequently. In light of these findings, it may be that manual therapy is a suitable low risk intervention that may offer relief to those who do not wish to take medication. There is a need for a lot more research into the management of this often debilitating condition. In particular, further investigation in needed in the class of cervicogenic headaches, responsible for 1 in 6 cases of headache, which has not been included in this NICE guideline. References (1). Effectiveness of manual therapy for chronic tension-type headache: a pragmatic, randomised, clinical trial. Castien RF, van der Windt DA, Grooten A, Dekker J. Cephalalgia. 2011 Jan;31(2):133-43. (2) Dose response and efficacy of spinal manipulation for chronic cervicogenic headache: a pilot randomized controlled trial. Haas M, Spegman A, Peterson D, Aickin M & Vavrek D. The Spine Journal 2010; 10:117-128. Our trusty boats For me, a relaxing holiday is spent 'doing something active'! I find that if I spend the day doing something physical then I have a good excuse to eat plenty of food and have a lazy evening. So, this summer we spent four days kayaking down the Thames. We'd done the first 50 miles a couple of years ago over a long weekend, and had always wanted to finish it. Near the start at Cricklade Two years ago, we had started at its source at Cricklade where the river was so shallow we had to walk down the stream, dragging our kayaks until it was deep enough for them, and us to float! (it was a 'dry summer' that year!). We followed the meandering course downstream, paddling through reeds and rushes and under the weeping willows, disturbing disgruntled swans and coots along the way. Slowly the river deepened and widened and we passed through Oxford, 'the city of dreaming spires', paddling along a stretch at Port Meadow - a piece of river I know well from my school days - and aside the beautiful college buildings in the University Parks. Then on to Abingdon where we ran out of daylight and time, so with 50 miles under our belt we put our Thames expedition on hold. Putting in at Abingdon This summer, we picked up literally where we had left off - carrying the kayaks across the water-meadow to put in under one of the arches on Abingdon Bridge. We covered 20-25 miles a day, setting a leisurely pace with time set aside to stop for well-deserved tea breaks. After all, we were on holiday! Stopping at locks and river-side pubs and cafes, we ensured that we didn't go hungry and anyway had 'emergency rations' and a flask safely stowed away in our kayaks - ideal for impromptu picnics. A fine place for a picnic... We took it easy, over-nighting at a rather smart hotel in Streatley (providing great entertainment for the guests at a riverside wedding as we clambered ashore, narrowly avoiding what would have been an eventful descent of the fast-flowing wier!), Henley and Eton. Plans to camp were scuppered by hostile 'get off my land' notices at any likely quiet stretch of river bank... One of many herons we saw - this was the first (and last!) we photo'd It was simply lovely to potter along the river, a little faster than walking pace, looking at the swans, geese, ducks, herons, moorhens, grebes and kingfishers. Ok, so these are cows, not sheep. I was reminded of passages from 'The Wind in the Willows' as we went 'all along the backwaters, through the rushes tall' - not surprising really as Kenneth Grahame first met Ratty, Mole and Mr Toad near his home at Cookham - a sleepy little riverside village in Oxfordshire. We rescued a young sheep that had fallen into the river and was too cold and tired to scramble up the steep bank - we could hear its joyous bleats as it frollicked in the meadow with its friends long after we had hauled it on shore! ...simply messing about in boats... It was surprising to see such a variety of wildlife, watermeadows and uninhabited rural spaces, even as we entered the more populated reaches around Staines and Slough - even into London. ...desirable riverside mansion... In addition to the abundant flora and fauna we were in prime position to spy on some of the gorgeous houses and mansions flanking the Thames. Impressive Georgian mansions with sweeping lawns to the river bank, home to a spinney of old oaks and a couple of hundred deer, or rambling Tudor houses with ancient beams and leaded windows. A boathouse is obviously a pre-requisite (some of these would have made a substantial home on their own!) together with the obligatory launch and skiff moored alongside. Behaving myself at a lock! Our journey coincided with the Olympics and as we kayaked along the stretch at Eton we could hear the cheers and screams and see the overhead cameras tracking the rowers at Dorney Lake. We even had a police escort some of the way - 'to ensure that there was no undue revelry at the nearby locks' - but the officers involved seemed to be enjoying their day pottering up and down the river, relaxing in the sunshine. The Finish! - Teddington Lock After four days we reached our destination - Teddington Lock. Beyond this point, the Thames becomes tidal as it passes through London, and special permits are required to venture beyond this point. The river becomes much bigger and wider and is the domain of tugs and dredgers, and whilst it would have been fun to see London from the river we decided to leave the last stretch for another time - one that wouldn't clash with London 2012! It really was a fantastic few days, and despite the aching shoulders and blistered hands, one that I would do again. There is nothing quite like 'simply messing about in boats' to restore the soul and recharge the batteries... |
Ceri AnnEich Ceiropractydd yng Nghlinig Ceiropracteg Llangefnii Blogumulus by Roy Tanck and Amanda Fazani
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